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Titolo:
INFLUENCE OF LONG-TERM, LOW-DOSE, DIURETIC-BASED, ANTIHYPERTENSIVE THERAPY ON GLUCOSE, LIPID, URIC-ACID, AND POTASSIUM LEVELS IN OLDER MEN AND WOMEN WITH ISOLATED SYSTOLIC HYPERTENSION - THE SYSTOLIC HYPERTENSION IN THE ELDERLY PROGRAM
Autore:
SAVAGE PJ; PRESSEL SL; CURB JD; SCHRON EB; APPLEGATE WB; BLACK HR; COHEN J; DAVIS BR; FROST P; SMITH W; GONZALEZ N; GUTHRIE GP; OBERMAN A; RUTAN G; PROBSTFIELD JL; STAMLER J;
Indirizzi:
UNIV TEXAS,HLTH SCI CTR,SCH PUBL HLTH,SHEP COORDINATING CTR,1200 HERMAN PRESSLER ST,SUITE 801 HOUSTON TX 77030 NHLBI,DIV CLIN APPLICAT,NIH BETHESDA MD 20892 UNIV HAWAII,JOHN A BURNS SCH MED HONOLULU HI 96822 UNIV TENNESSEE MEMPHIS TN 00000 VET AFFAIRS MED CTR MEMPHIS TN 00000 RUSH PRESBYTERIAN ST LUKES MED CTR CHICAGO IL 60612 NORTHWESTERN UNIV,SCH MED CHICAGO IL 00000 WASHINGTON UNIV,SCH MED ST LOUIS MO 00000 UNIV CALIF SAN FRANCISCO SAN FRANCISCO CA 94143 UNIV MINNESOTA MINNEAPOLIS MN 00000 UNIV KENTUCKY LEXINGTON KY 00000 UNIV ALABAMA BIRMINGHAM AL 00000 UNIV WASHINGTON SEATTLE WA 98195
Titolo Testata:
Archives of internal medicine
fascicolo: 7, volume: 158, anno: 1998,
pagine: 741 - 751
SICI:
0003-9926(1998)158:7<741:IOLLDA>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; BLOOD-PRESSURE; DIABETES-MELLITUS; RISK-FACTORS; INTOLERANCE; DRUGS; DISTURBANCES; METABOLISM; FRAMINGHAM; TOLERANCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
P.J. Savage et al., "INFLUENCE OF LONG-TERM, LOW-DOSE, DIURETIC-BASED, ANTIHYPERTENSIVE THERAPY ON GLUCOSE, LIPID, URIC-ACID, AND POTASSIUM LEVELS IN OLDER MEN AND WOMEN WITH ISOLATED SYSTOLIC HYPERTENSION - THE SYSTOLIC HYPERTENSION IN THE ELDERLY PROGRAM", Archives of internal medicine, 158(7), 1998, pp. 741-751

Abstract

Background: Previous studies often of short duration have raised concerns that antihypertensive therapy with diuretics and beta-blockers adversely alters levels of other cardiovascular disease risk factors. Methods: The Systolic Hypertension in the Elderly Program was a community-based, multicenter, randomized, double-blind, placebo-controlled clinical trial of treatment of isolated systolic hypertension in men and women aged 60 years and older. This retrospective analysis evaluated development of diabetes mellitus in all 4736 participants in the Systolic Hypertension in the Elderly Program, including changes in serum chemistry test results in a subgroup for 3 years. Patients were randomized to receive placebo or treatment with active drugs, with the dose increased in stepwise fashion if blood pressure control goals were not attained: step 1, 12.5 mg of chlorthalidone or 25.0 mg of chlorthalidone; and step 2, the addition of 25 mg of atenolol or 50 mg of atenolol or reserpine or matching placebo. Results: After 3 years, the active treatment group had a 13/4 mm Hg greater reduction in systolic and diastolic blood pressure than the placebo group (both groups, P < .001). New cases of diabetes were reported by 8.6% of the participants in the active treatment group and 7.5% of the participants in the placebo group (P = .25). Small effects of active treatment compared with placebo were observed with fasting levels of glucose (+0.20 mmol/L [+3.6 mg/dL]; P < .01), total cholesterol (+0.09 mmol/L [+3.5 mg/dL]; P < .01), high-density lipoprotein cholesterol (-0.02 mmol/L [-0.77 mg/dL]; P < .01) and creatinine (+2.8 mu mol/L [+0.03 mg/dL]; P < .001). Larger effects were seen with fasting levels of triglycerides (+0.9 mmol/L [+17 mg/dL]; P < .001), uric acid (+35 mu mol/L [+.06 mg/dL]; P < .001), andpotassium (-0.3 mmol/L; P < .001). No evidence was found for a subgroup at higher risk of risk factor changes with active treatment. Conclusions: Antihypertensive therapy with low-dose chlorthalidone (supplemented if necessary) for isolated systolic hypertension lowers blood pressure and its cardiovascular disease complications and has relatively mild effects on other cardiovascular disease risk factor levels.

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Documento generato il 04/12/20 alle ore 14:50:13